Case Report: The Heparin Flush Syndrome: A Cause of Iatrogenic Hemorrhage

Keeping central venous lines open: a prospective comparison of heparin, vitamin C and sodium chloride sealing solutions in medical patients

“…If increased catheter patency is important, these catheters should be sealed with 5000 U/ml heparin solution. However, while there were no complications from heparin administration (such as bleeding or heparin-induced thrombocytopenia) in our series, systemic effects of heparin [9] or the development of heparin-induced thrombocytopenia may be a problem.…”

“…Especially the use of vitamin C for sealing intermittently used central venous catheters is widely practiced in German dialysis units and on medical wards. It is believed to be safer than flushing these catheters with other anticoagulants that may have severe and sometimes live-threatening side effects such as bleeding (heparin) [9], heparininduced thrombocytopenia type II (heparin) or arrhythmias (citrate). However, vitamin C has never been tested prospectively against other anticoagulants.…”

Natural Saline-Flush Is Sufficient to Maintain Patency of Immobilized-Urokinase Double-Lumen Catheter Used to Provide Temporary Blood Access for Hemodialysis

“…Although no signs of bleeding tendency were observed in the heparin group in the present study, natural saline-fl ush should be recommended to avoid potential adverse effects of heparin, especially for postoperative patients, those with bleeding diseases, or those undergoing invasive procedures. Especially heparin-induced thrombocytopenia or 'heparin-fl ush syndrome' may occur with a low incidence [5,6] , and a larger-scale randomized controlled trial with a longer period of observation would be required to clarify whether the incidence of adverse clinical events induced by heparin-lock differs or not.…”

O uso de catéter heparinizado em hospitais de Belo Horizonte

“…Observou-se urn caso de trombocito penia associada a tromboembolismo e outro caso de hemorragia p6s operat6rio. (8,9) Foram fe itos estudos comparativos entre solu�ao heparinizada e NaCI a 0,9% para manuten�o do cateter, e os autores obtiveram como resultado, 0 dobro de pun�oes venosas decorrente da perda de acesso venoso em pacientes que usaram NaCI puro. Chegou-se a conclusao que a heparina e mais eficien te para a manute�ao de cateter intermitente .…”

“…0 controle de sua ac;ilo deve serfeito atraves da determinac;lio do tempo de coagulac; il<> . (10) A heparina e usada na profilaxia de fenomenos trombo-emb6licos, tromboses venosas, insuficiencia coronariana, infarto agudo do miocardio, cirurgias cardiacas, no emprego do rim artificial e em casos de A heparina inibe a ac;lio da trombina sabre 0 fibrinogenio, podendo ocorrer hemorragias ate fatai s, assim como trombocitopenia com feoomenos trom b oem b6li cos. (8,9,10) …”